Features

“Virus Hunter”

by Eric Eyges

Spring/Summer 2020

Ghazi Kayali is in a cave in the Beqaa Valley trailed by a team of filmmakers shooting the mini-series Pandemics for Netflix. They’re pointing their night vision cameras at stalactites dripping water, accentuating the silence. Kayali, or one his colleagues—it’s unclear in the darkness—shines his helmet light on a group of bats that screech in dismay.

Filmed during the 2018–19 flu season, Pandemics introduces Kayali as “a watchman,” a man on the frontier of the global struggle against would-be pandemics. “Virus hunter” is also a term now being circulated in the media to describe scientists like Kayali who spend their days in caves, fields, and on farms collecting blood, saliva, and fecal samples from animals in their search for pathogens that might make the leap from animal to human; the global scientific consensus is that the current strain of coronavirus infecting humans made just such a leap.

In the Netflix series, Kayali’s work represents virus hunters operating in the Middle East and North Africa. He says matter-of-factly that Human Link (HL)—the NGO he founded and through which he receives funding, operates labs, and does field research—is the only organization of its kind in the region. “I was looking for jobs after my post-doc in 2014. I had some offers to become an assistant professor, but that meant a lot of teaching. I enjoy being out in the field.”

HL collaborates on research in Lebanon with students and faculty from AUB. In Cairo, it operates through the Center for Scientific Excellence for Influenza Viruses, a partnership initiative with the Egyptian National Research Centre aimed at assisting the Egyptian government in combating bird flu (H5N1 and H9N2).

“I did my post-doc in animal influenza viruses, then focused on avian flu. There was extra funding coming in for Africa and the Middle East, so I moved to Cairo with that money and started working there.” HL, Kayali explains, operates in Lebanon as an NGO and in Cairo serves as a repository for research funds from its primary benefactor, the US National Institutes of Health.  

Money is one of the primary barriers to running a fieldwork-focused research lab in the Middle East. “It’s expensive work, much more than regular lab work. In any given year, I need $500,000 to run our lab. In the US, the most common lab grant is the R1 for $250,000. And that’s for US salary scales.”

Proper funding is also important because of the need for “biosecurity” that comes when dealing with live viruses that have the potential to escape and cause an outbreak.

“It’s been easy for us to shift to COVID-19 because we already had the tools available from our work on MERS.” The appearance of MERS-CoV in Saudi Arabia in 2012 helped HL get more access to research funds, “on top of what we were getting for the avian flu. We were able to establish a surveillance network in other Middle Eastern countries.”

Having studied infectious diseases since the 1990s, Kayali is able to see COVID-19 in the context of recent history. “For a long time people had forgotten about infectious diseases. Common ones like chickenpox and mumps had been brought under control. Then came a major outbreak of bird flu in Hong Kong and people started paying attention again.” Warzones, he says, tend to be hotspots for outbreaks, as has happened in Yemen where cholera has reappeared. “Infectious diseases return when you have a breakdown in health systems.”

The current pandemic, he says, is a pandemic because of its transmission rate. “For the flu it’s one [additional person infected per infected person], for SARS, it’s two to three. This one is moving around pretty quickly. People are shedding the virus and not showing symptoms.”

He offers much insight into the current global challenges with testing. “When the Chinese posted their genomic sequence [of the new coronavirus], several groups around the world immediately started developing their own protocols.” By this, he means taxonomies or ways of identifying the virus based on its biology. One firm may develop a test that looks for certain RNA markers, while another may develop a test that looks for different ones. A test results from a starting protocol or set of markers. There is no universal test, but labs in Germany and Hong Kong developed protocols soon after the new sequence appeared. And companies around the world continue to develop and improve tests based on different protocols.

“The CDC decided to develop their own assay [test], and it didn’t work,” Kayali says. Scientists from the CDC read the sequence and created a protocol and a test kit, but they had to withdraw it after having distributed it to state hospitals around the country. “They did what they were supposed to do. You can always have a technical problem somewhere along the line. Maybe it was a faulty reagent, maybe human error. You never know.”

Could America’s testing problem be solved by public health insurance? “It’s about economics.” Kayali explains that it costs more to run a lab in Europe or the United States, and so it costs more for those countries to develop tests, than say, China. The costs of testing will go down as the supply increases, and, one assumes, testing will become more widespread. “As Dr. Fauci would tell you, testing is what’s important,” Kayali says with a smile.  

In the long run, Kayali sees a “one health” philosophy as key to addressing potential pandemics. He emphasizes the idea that animal, human, and environmental health are interconnected and must be considered that way when it comes to public health. “It’s not a new philosophy. A physician and a veterinarian came up with the TB vaccine,” he says.